老年轻中度原发性高血压患者家庭自测血压变异与冷加压试验的相关性

Association between self-measured blood pressure variability at home and cold pressor test in elderly patients with mild-moderate EH

目的 探讨老年轻中度原发性高血压患者家庭自测血压变异与冷加压试验的相关性.方法 于2012年5月～2013年8月自山东省临沂市兰山区高血压社区管理的高血压患者中,筛选老年轻中度原发性高血压患者259例,所有入选受试者均进行7d家庭血压自测,计算后6d连续的收缩压及舒张压变异性相关指标及平均心率;采用冷加压试验以刺激全身交感神经兴奋,并将冷加压试验阳性作为阳性组11 6例,冷加压试验阴性作为阴性组143例.结果 阳性组早间舒张压、收缩压标准差、舒张压标准差、最高收缩压、最高舒张压、早-晚收缩压差、早晚舒张压差、最高-最低收缩压差、最高-最低舒张压差,平均心率均高于阴性组（P＜0.05）.阳性组晚间收缩压、晚间舒张压低于阴性组（P＜0.05）.回归分析显示,即刻及60 s收缩压变化幅度始终是影响收缩压标准差、舒张压标准差、早-晚收缩压差、早-晚舒张压差、最高-最低收缩压差及最高-最低舒张压差的主要因素.结论 老年轻中度原发性高血压患者的家庭自测血压变异与冷加压试验反应相关,冷加压试验反应越强,血压变异越大.

Objective To study the association between self-measured blood pressure variability at home and cold pressor test （CPT） in elderly patients with mild-moderate essential hypertension.Methods Two hundred and fifty-nine elderly patients with mild-moderate essential hypertension selected from Lanshan District of Linyi City,Shandong Province,China in May 2012-August 2013 were included in this study.The paitnts measured their blood pressure at home for 7 days.Their systolic blood pressure （SBP） and diastolic blood pressure （DBP） variabilities and mean heart rate were calculated for the later 6 days.The patients who underwent CPT were divided into positive CPT group （n=116） and negative CPT group（n=143）.Results The difference in morning DBP,SD of SBP and DBP,maximum SBP and DBP,morning and evening SBP and DBP,maximum and minimum SBP and DBP,and mean heart rate was significantly higher while the evening SBP and DBP were significantly lower in positive CPT group than in negative CPT group （P〈0.05）.Logistic regression analysis showed that the SBP variability at 0 and 60 s was the major factor for the SD of SBP and DBP,morning and evening SBP and DBP,maximum and minimum SBP and DBP.Conclusion Self-measured blood pressure variability at home is related with the response to CPT in elderly patients with mild-moderate essential hypertension.The stronger the response to CPT is,the greater the blood pressure variability is.